Medical Biller

Job Title: Ambulatory Medical Biller

Job Description:

We are seeking a skilled and experienced medical biller with a minimum of 5 years of ambulatory billing experience, preferably with expertise in the Allscripts billing systems. The ideal candidate will have a strong background in orthopedic billing, although it's not mandatory. As a crucial member of our team, you will be responsible for accurately and efficiently processing medical claims and ensuring timely reimbursement for services rendered.

Responsibilities:

1. Billing and Coding: Utilize your expertise in medical coding (CPT, ICD-10, HCPCS) to accurately assign appropriate codes to medical services and procedures performed in an ambulatory setting.

2. Allscripts System Management: Demonstrate proficiency in navigating and utilizing the Allscripts billing system to input patient demographic information, manage claims, and resolve billing-related issues.

3. Claims Processing: Submit claims to insurance companies electronically or via paper, ensuring accuracy and compliance with payer requirements. Follow up on unpaid or denied claims, identify reasons for denial, and take appropriate action to resolve outstanding balances.

4. Payment Posting: Post payments and adjustments accurately to patient accounts, reconcile payments with EOBs (Explanation of Benefits), and identify and address discrepancies.

5. Insurance Verification: Verify patient insurance coverage and eligibility, obtain pre-authorizations when necessary, and communicate effectively with insurance companies to resolve coverage-related issues.

6. Patient Billing and Collections: Generate patient statements, answer billing inquiries, and assist patients with understanding their financial responsibilities. Follow up on outstanding patient balances and establish payment arrangements as needed.

7. Compliance: Ensure compliance with all relevant healthcare regulations, including HIPAA and billing guidelines set forth by government and third-party payers.

Requirements:

1. Minimum of 5 years of experience in ambulatory medical billing, with a strong preference for candidates with orthopedic billing experience.
2. Proficiency in Allscripts billing system is required.
3. In-depth knowledge of medical billing practices, including CPT, ICD-10, and HCPCS coding.
4. Excellent attention to detail and accuracy in data entry and claims processing.
5. Strong communication skills, both written and verbal, with the ability to effectively interact with patients, providers, and insurance companies.
6. Ability to work independently and collaboratively within a team environment, prioritizing tasks to meet deadlines.
7. Demonstrated problem-solving skills and the ability to adapt to changing priorities and workflows.
8. Certification in medical billing and coding (e.g., CPC, CCS-P) is preferred but not required.

If you meet these qualifications and are looking for a challenging yet rewarding opportunity in ambulatory medical billing, we encourage you to apply and become part of our dynamic team.